Finance and Business Strategy

Note: The second section of this article was updated where noted with a new comment from Fitch Ratings. There is reason to be optimistic about the state of hospital finances, but the impact of the Change Healthcare cyberattack has added uncertainty to the forecasts. Financial metrics for the first two months of 2024 continued to…

During the chaotic runup to the 2020 elections, President Trump nominated Judge Amy Coney Barrett to fill Ruth Bader Ginsberg’s vacated seat. On Sept. 26, 2020, Trump held a White House Rose Garden ceremony to celebrate Coney Barrett’s nomination. It became a COVID-19 super-spreader event. At least 11 of the attendees contracted COVID. They included…

As health systems progress through 2024, they will require effective governance to successfully navigate the rising headwinds. As they plan and execute initiatives, their leaders and boards should remain informed about eight key trends that will have a growing impact on the industry and the future success of their organizations. 1 Continued big technology M&A…

Health system leaders focused on the day-to-day needs of their organization can sometimes lose sight of key developments in other sectors of healthcare. But in an interconnected healthcare ecosystem, understanding the trendlines their payer counterparts are facing is essential. Threats to payers While some health system leaders might be under the impression that payers are…

Hospitals will get a more favorable Medicare payment increase in FY25 if Congress follows the recommendations of the Medicare Payment Advisory Commission (MedPAC). In its semiannual report to Congress, MedPAC recommended a 1.5% bump on top of what otherwise would be provided according to statute. That would mean an estimated increase of about 4.5% for…

Note: This information is excerpted from HFMA’s running coverage of the cyberattack that disabled operations at Change Healthcare. On March 10, HHS and the Department of Labor sent a letter encouraging commercial payers to do their part to help financially strained providers nearly three weeks after the cyberattack on Change Healthcare. “Larger payers in particular…

Headline: The Sixth Annual Hospital Price Transparency Compliance ReportSource: Patient Rights AdvocatePublished: February 2024 PatientRightsAdvocate.org recently issued its sixth report scoring hospital compliance with federal price transparency regulations, and for the sixth time, its assessment conflicts with CMS’s assessment. I want to focus on a nugget we picked up on in the methodology section of the latest report,…

The Biden administration is ramping up its assessment of how to regulate consolidation and private equity (PE) acquisitions in healthcare, issuing a request for information (RFI) from stakeholders. There is a deadline of May 6 to submit comments on the RFI, which was distributed by HHS, the Department of Justice (DOJ) and the Federal Trade…

GLP-1 agonists, medications originally formulated to treat diabetes, have gained traction as prescription drugs for weight loss. On this episode, medical researcher and patient advocate Ragen Chastain discusses what healthcare providers should be sharing with their patients about the risks and efficacy of Wegovy and Zepbound.

Just as hospitals, health systems and physician practices are dealing with unprecedented financial and operational challenges, denied claims continue to rise — especially medical necessity denials. The impact on providers and patients is significant. Medical necessity is the term used to describe “healthcare services or supplies needed to diagnose or treat an illness, injury, condition,…